November 10, 2005

New Outpatient Treatment Program

A new bill is currently being reviewed by the Pennsylvania state senate Public Health and Welfare Committee, which would change the way mental health treatment is administered by the state, particularly outpatient treatment. The bill, SB 213, was introduced by Sen. Stewart Greenleaf, R-Montgomery County, as an amendment to the Mental Health Procedures Act last February and is cosponsored by Sen. Ted Erickson, R-26 of Newtown Square. The bill, which is similar to New York's "Kendra's Law", would allow the court to mandate outpatient treatment for individuals who have a history of not complying with treatment that is necessary to prevent them from becoming violent and harming themselves or others. The treatment would be monitored by a case manager or team and could include "medication, blood tests or urinalysis to determine compliance with prescribed medications, individual or group therapy, day or partial programming activities, educational and vocational training, alcohol or substance abuse treatment, and supervision of living arrangements". If this outpatient approach were unsuccessful, the individual could be evaluated under the "clear and present danger" standard for involuntary commitment. However, according to Erickson, the goal of SB 213 is to avoid "unnecessarily institutionalizing the individual. Hopefully, you intervene in an outpatient setting before people do something violent". Before being ordered into this program, patients would have the right to due process and other protections, including a petition, hearing, right to counsel, physician's affidavit, and the development of an alternative treatment program.

Of course, not everyone agrees that the bill should be passed. Advocates believe that this bill would get help to many individuals who lack insight into their disease, those who need treatment but don't realize that they need it. The Treatment Advocacy Center, a national, non-profit organization "working to eliminate barriers to timely treatment of severely mentally ill individuals," claims that, under current law, Pennsylvania "essentially forces people who lack insight into their illness to hit rock bottom before they can be helped". They also believe that the state needs a better method of outpatient treatment, to give individuals more options and not force them into institutions. But will SB 213 do the trick? Opponents of the bill say it should not be passed because it forces people into treatment when it should be a voluntary undertaking. Many people, especially those who have been involuntarily committed in the past, are frightened at the prospect of being forced into a treatment program. Ronald L. Berman, state mental-health consumer and advocate, said he disagreed with the bill because it "does not treat people with dignity and respect". Two notable organizations, NAMI Pennsylvania (National Alliance on Mental Illness) and the American Civil Liberties Union of Pennsylvania, say they must examine the bill more closely before taking a stand.